What Many Back Pain Sufferers Can Do at Home

3 Apr

Low back pain (LBP) is a very common problem that affects most of us at some point in life and for some, it’s a daily issue. Through education and research, researchers have found low back-specific exercises can not only help get rid of LBP but can also prevent future exacerbations or episodes. Like brushing our teeth, low back exercises are equally important in order to maintain, preserve, and optimize function. But because there are SO MANY exercise options available, it’s hard to know which ones are best, especially for each specific person.

There are different methods for determining the right low back exercises for the patient. One of the most common is to try different exercises to determine individual tolerance, but this is not very specific, as it only determines whether or not the patient is comfortable with an exercise. Another is using physical performance tests (PPTs) that measure the strength and endurance of specific muscle groups, muscle shortness, balance, aerobic capacity, and spinal range of motion.

Physical performance tests are much more specific because they address each patient’s differences. Also, many PPTs include normative data to compare against the patient’s own performance, so repeat use of the abnormal PPTs on a monthly interval can gauge their progress (or the lack thereof), which is motivating to the patient and serves as a great outcome measure!

PPTs are typically done two to four weeks after an initial presentation or at a time when the condition is stable so as not to irritate the condition. Initially, the decision as to which exercise is best is often made by something called “directional preference” or positional bias. This simply means if a patient feels best by bending over, we initially give “flexion-biased” exercises.

Flexion-biased exercises include (partial list): pulling the knees to the chest (single then double), posterior pelvic tilts (flattening the low back into the floor), sitting and/or standing bend overs, hamstring stretches, and more. If a person’s low back feels best bending backwards, their doctor of chiropractic may give extension-biased exercises, which include (partial list): standing back bends, saggy push-ups (prone press-ups), and/or laying on pillows or a gym ball on their back, arching over the ball.

Chiropractors generally add exercises gradually once they’ve determined tolerance and will recheck to make sure the patient is doing them correctly. Studies show that spinal manipulation achieves great short-term results, but when exercise is added to the treatment plan, the patient can achieve a more satisfying long-term result. Unfortunately, other studies have shown that ONLY 4% of patients continue their exercises after pain is satisfactorily managed and they fall back into old habits of not exercising.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055
Member of Chiro-Trust.org

High-Intensity Interval Training – What Is That?

27 Mar

High-intensity interval training (HIIT) is characterized by 30-60 second bouts of high-intensity output followed by a very low-intensity exercise (like walking or slow pedaling) which allows one’s heart rate and breathing to recover before the next high-intensity segment.

Studies have shown HIIT can produce similar results as low-intensity aerobic exercise, but with significant differences in intensity, duration, and energy output. HIIT participants can experience improved maximal rate of oxygen uptake (VO2max), improved skeletal muscle capillarization, increased enzymes of fat metabolism, and improved insulin sensitivity—all of which result in better overall health-status and physical performance.

Three separate studies report that HIIT can reduce one’s body fat percentage using durations of only nine total minutes high-intensity activity per week—without controlling food intake! A 2016 study looked at even shorter weekly time durations and included both male and female participants to see what differences exist between the sexes.

The study involved 24 men (average age 38) and 17 women (average age 41) who performed HIIT three mornings a week using a cycle ergometer followed by a blood sample draw over the course of twelve weeks. Their routine consisted of a two-minute warm-up (moderate intensity) followed by four bouts of 20 seconds at maximum effort (set at 175% of the workload attained in the VO2max test) separated by two-minute recovery bouts using very low-intensity cycling (~20% VO2max).

After the three-month study, the participants experienced a lower body fat percentage (average 1%), higher rates of fatty acid oxidation (average 13%), and a greater VO2max (average 9%). Women had greater gains in their VO2max than men, while men lost more fat than the women. Keep in mind the participants only engaged in high-intensity activity a total of 240 seconds per week!

The “TAKE HOME” message is that if you don’t enjoy spending 30-60 minutes per day doing aerobic exercises, then HIIT may be something to consider, as it can produce similar (sometimes even better) results in less time.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

 

Posture and Whiplash

20 Mar

Posture assessment is a key component of the chiropractic examination, and the posture of the head and neck is especially important for a patient recovering from a whiplash injury. Forward head carriage describes a state in which the head sits more forward on the shoulders than it should. In order for the muscles in the neck and shoulders to keep the head upright, they must work harder. This added strain can increase one’s risk for neck pain and headaches, which is why retraining posture is a key component to the management of neck pain and headaches in patients with or without a history of whiplash.

Forward head carriage also increases the distance between the back of the head and the headrest in the seated position, especially when the seat is reclined. In a rear-end collision, a gap greater than a half an inch between the head rest and the back of the head increases the probability of injury due to the greater distance the head can hyperextend as it rebounds backwards into the headrest.  This makes posture correction of forward head carriage an important aspect of treatment from both a preventative and curative perspective.

So this begs the question, can forward head carriage be corrected?  The simple answer is “yes!” One study evaluated the effects of a 16-week resistance and stretching program designed to address forward head posture and protracted shoulder positioning.

Researchers conducted the study in two separate secondary schools with 130 adolescents aged 15–17 years with forward head and protracted shoulder posture. The control group participated in a regular physical education (PE) program while the experimental group attended the same PE classes with the addition of specific exercises for posture correction. The research ream measured the teens’ shoulder head posture from the side using two different validated methods and tracked symptoms using a questionnaire. The results revealed a significant improvement in the shoulder and cervical angle in the experimental group that did not occur in the control group.

The conclusion of the study strongly supports that a 16-week resistance and stretching program is effective in decreasing forward head and protracted shoulder posture in adolescents.  This would suggest that a program such as this should be strongly considered in the regular curriculum of PE courses since this is such a common problem.

Doctors of chiropractic are trained to evaluate and manage forward head posture with shoulder protraction. This can prove beneficial in both the prevention as well as management of signs and symptoms associated with a whiplash injury.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder 4909 Louise Drive, Suite 102 Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

Where Does Your Neck Pain Come From?

16 Mar

Let’s first look at the anatomy of the neck in order to better understand the structures of the cervical spine that can generate pain.

Starting at the back of the spine, the facet joints allow us to move our neck and head in all directions, and each facet joint is surrounded by a joint capsule that is rich with nerve endings and when swollen, can generate pain both locally and radiating.

One study of volunteers with existing neck pain looked at the various pathways that pain travels when investigators injected each individual facet joint capsule with normal saline solution. Interestingly, the subjects felt pain in parts of the body other than just the neck.  For example, injecting the C6 facet joint capsule consistently reproduced radiating pain down the arm into the thumb side of the forearm and hand, similar to when a disk herniates and a nerve root is pinched. The primary difference was that a deep aching pain occurred in this area, as opposed to a more geographically well-defined pathway when a disk ruptures and pinches a specific nerve root.

The intervertebral disks are small shock absorbers that lie between each vertebral body. These disks are sort of like a jelly doughnut, which can sometimes leak out and pinch a nerve root producing pain (as well as numbness, tingling, and even weakness) that radiates along the course of the nerve.

Poor posture is perhaps one of the most common causes of neck pain. The muscles in the chest tend to be stronger than those in the upper back and pull the shoulders forward resulting in forward head carriage with protracted shoulders. For each inch of forward head shift, an additional ten pounds is added to the weight of the head, which already weights around ten to twelve pounds. Hence, a five-inch forward head carriage places an additional 50 pound load on the upper back and neck just to hold the head upright!

Doctors of chiropractic are trained to identify these faulty postures and track down the pain generator(s) when a patients presents with neck pain. Through patient education, spinal manipulation, mobilization, exercise training, modalities, and more, chiropractors can greatly help those struggling with neck pain!

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

 

Is a Labral Tear Causing Your Hip Pain?

13 Mar

One of the structures that is frequently blamed for hip pain is called the labrum—the rubbery tissue that surrounds the socket helping to stabilize the hip joint. This tissue often wears and tears with age, but it can also be torn as a result of a trauma or sports-related injury.

The clinical significance of a labral tear of the hip is controversial, as these can be found in people who don’t have any pain at all. We know from studies of the intervertebral disks located in the lower back that disk herniation is often found in pain-free subjects—between 20-50% of the normal population.  In other words, the presence of abnormalities on an MRI is often poorly associated with patient symptoms, and the presence of a labral tear of the hip appears to be quite similar.

For instance, in a study of 45 volunteers (average age 38, range: 15–66 years old; 60% males) with no history of hip pain, symptoms, injury, or prior surgery, MRIs reviewed by three board-certified radiologists revealed a total of 73% of the hips had abnormalities, of which more than two-thirds were labral tears.

Another interesting study found an equal number of labral tears in a group of professional ballet dancers (both with and without hip pain) and in non-dancer control subjects of similar age and gender.

Another study showed that diagnostic blocks—a pain killer injected into the hip for diagnostic purposes to determine if it’s a pain generator—failed to offer relief for those with labral tears.

Doctors of chiropractic are trained to identify the origins of pain arising from the low back, pelvis, hip, and knee, all of which can mimic or produce hip symptoms.  Utilizing information derived from a careful history, examination, imaging (when appropriate), and functional tests, chiropractors can offer a nonsurgical, noninvasive, safe method of managing hip pain.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

 

The Evils of Dormant Butt Syndrome and How to Save Money in a Medical Environment

9 Mar

Our basic premise is that your body is amazing.  You get a do over. It doesn’t take that long, and it isn’t that hard if you know what to do.  In these notes, we give you a short course in what to do so it becomes easy for you and for you to teach others. We want you to know how much control you have over both the quality and length of your life.

This month, I want to give you two tips—one on how to save money in a medical environment (from my new book) and one on dormant butt syndrome (DBS).  Let’s start with DBS.

Riddle me this… What do Mia Hamm, Michael Phelps, and NFL quarterbacks all have in common? Toned glutes! And if you think that’s not something to comment on—take a seat and listen up. According to Ohio State University Wexner Medical Center physical therapist Chris Kolba, PhD, millions of North Americans who sit all day at work or are generally sedentary have developed Dormant Butt Syndrome (DBS).

And those flaccid backsides aren’t just making your pants look baggy, they contribute to a roster of back, hip, and knee problems. Your butt muscles support your pelvis, hips, and torso and act as a shock absorber when you walk. But if they’re dormant, you end with tight hip flexors, lower back pain, and even knee problems that can lead to a meniscus injury. So get up off that backside!

Did you know more than half of you sit for at almost eight hours a day? Sitting six or more hours a day elevates your risk of dying from cancer and other major diseases!  But changing your habits so you sit for less than three hours a day can add an extra two years to your lifespan.

So, stand up every 30-60 minutes—go walk the stairs in your office building, speed walk around the parking lot, and/or do stretches at your desk. At home, try stretch bands while you watch TV. Get a pedometer and aim for 10,000 steps daily.

Avoiding DBS is one way to reduce medical expenses.  Here is an even more powerful way to stay healthy and save medical expenses: meditate for 5 minutes each morning and each night. This alone reduced expenses and the need for medical encounters by 43% in one recent study from the Benson-Henry Institute at Harvard (PLOS One October 13, 2015). That’s not a typo, forty-three percent!  Stress is the greatest ager and financial stress needs to be dealt with directly (see our book AgeProof: Living Longer Without Running Out of Money or Breaking a Hip). But meditation alone in studies at Cleveland Clinic resulted in reduced costs, a 7% increase in productivity, and both weight loss and waist-loss. It’s easy to do, too.  Online programs that teach 8 different techniques of mindfulness (you only need use one) abound like Cleveland Clinic’s StressFreeNow with e-coaching.

Thanks for reading. Feel free to send questions—to youdocs@gmail.com, and some of them we may know enough to answer (we’ll try to get answers for you if we do not know).

Young Dr Mike Roizen (aka, The Enforcer)

PS: Please do look for and order the new book by Jean Chatzky and myself, AgeProof: Living Longer Without Running Out of Money or Breaking a Hip, that was released on February 28th, 2017.

NOTE: You should NOT take this as medical advice.
This article is of the opinion of its author.
Before you do anything, please consult with your doctor.

You can follow Dr Roizen on twitter @YoungDrMike (and get updates on the latest and most important medical stories of the week). The YOU docs have two newly revised books: The patron saint “book” of this column YOU Staying Young—revised and YOU: The Owner’s Manual…revised —yes a revision of the book that started Dr Oz to being Dr Oz. These makes great gifts—so do YOU: ON a Diet and YOU: The Owner’s Manual for teens.

Michael F. Roizen, M.D., is chief wellness officer and chair of the Wellness Institute at the Cleveland Clinic. His radio show streams live on http://www.radioMD.com Saturdays from 5-7 p.m. He is the co-author of 4 #1 NY Times Best Sellers including: YOU Staying Young.

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